Analysis Of Risk Factors For Arterial Switch Operation Short-term Prognosis

Objective Analysis of risk factors that prolong hospital stay and short term mortality after ASO. Methods A retrospective analysis of Tianjin Thoracic Hospital pediatric cardiac surgery from December 2007 to December 2015, 53 cases underwent ASO data. Postoperative hospitalization(6-61 days; Q3=18 days). With the time of hospitalization after operation, divided into two groups, Extended recovery(A group of 42 cases, 79.2%), normal recovery(group B, 11 cases, 20.8%). With the postoperative death is divided into death group(3 cases in group C, 5.7%), Non death group(50 cases in group D, 94.3%). SPSS software was used to compare the clinical data of the two groups respectively, and the single factor analysis was performed. Result All 53 cases in the operation of the age(31.6±22.4) days,weight(4.0±0.8) Kg, height(55.6±9.5) cm. 3 patients died after ASO(5.7%), 1 patient died of late surgery among them(2%). Comparison between A group and B group: Taussig-Bing: 5 cases(45.5%) VS 4 cases(9.5%), Preoperative acidosis: 11 cases(100.0%) VS 19 cases(45.2%), Preoperative circulatory instability: 11 patients(100.0%) VS 16 patients(38.1%), CPB-time:(201.3±41.1) minutes VS(172.2±43.0) minutes, Aorticcross clamping time:(137.9±31.7) minutes VS(103.4±24.8) minutes, of Acute kidney injury: 9 cases(81.8%) VS 15 cases(35.7%), LCOS: 2 cases(18.2%) VS 0 cases(0.0%), Mechanical ventilation time:(285.9±220.4) hours VS(66.0±47.4) hours. Comparison between C group and D group: Early surgery in 2 cases(50.0%) VS 2 cases(50.0%), Later stage: 1 case(2.0%) VS 48 cases(96.0%), LCOS: 2 cases(66.7%) VS 0 cases(0.0%), Respiratory failure: 2 cases(66.7%) VS 2 cases(4.0%), Postoperative pulmonary artery stenosis: 3 cases(100.0%) VS 2 cases(4.0%), CPB-time:(232.7±106.8) minutes VS(174.9±37.2) minutes, Postoperative AST value:(255.3±47.1) U VS(96.1±48.6) U. Univariate analysis showed: Taussig-Bing, acidosis, unstable circulation, CPB-time and aortic cross-clamping, Acute kidney injury, LCOS and mechanical ventilation time the group A and group B were statistically significant(P<0.05). Early surgery, CPB-time, Postoperative pulmonary artery stenosis, LCOS, Respiratory failure, elevated AST the group C and group D were statistically significant(P<0.05). Conclusion ASO has achieved good therapeutic effect in treatment of TGA and Taussig-Bing syndrome. The risk factors influencing the short-term prognosis of ASO were: Operation in the early, diagnosis of Taussig Bing syndrome, preoperative acidosis and circulatory instability, cardiopulmonary bypass time, aortic blocking for a long time, postoperative acute renal damage, low cardiac output syndrome, pulmonary artery stenosis and long time on a ventilator.